Corpus Callosum Holes



Corpus Callosum Holes


Karen L. Salzman, MD



DIFFERENTIAL DIAGNOSIS


Common



  • Multiple Sclerosis


  • Diffuse Axonal Injury (DAI)


Less Common



  • Post-Surgical


  • ADEM


  • Obstructive Hydrocephalus


  • Lacunar Infarction


Rare but Important



  • Enlarged Perivascular Spaces


  • Marchiafava-Bignami Disease


  • Susac Syndrome


ESSENTIAL INFORMATION


Helpful Clues for Common Diagnoses



  • Multiple Sclerosis



    • Callososeptal interface T2 hyperintensities


    • “Burned out” chronic lesions have T1 hypointense center, very slight hyperintense rim (lesion within lesion)


  • Diffuse Axonal Injury (DAI)



    • Punctate hemorrhages at gray-white interfaces & corpus callosum (CC) typical


    • “Blooming” on T2*, GRE, SWI common


    • May result in focal encephalomalacia


Helpful Clues for Less Common Diagnoses



  • Post-Surgical



    • Small CC “holes” common after shunt


    • Defects may result from transcallosal surgery (e.g., for colloid cyst)


  • ADEM



    • Both subcortical white matter (WM), deep gray nuclei often involved


    • May mimic multiple sclerosis


  • Obstructive Hydrocephalus



    • Dorsal, middle layers may show T1 hypointense & T2 hyperintense signal


    • May be related to CC compression against falx during acute ventricular obstruction


  • Lacunar Infarction



    • Uncommon; rich blood supply to CC


    • Focal ischemia with surrounding gliosis


    • Supplied by anterior communicating artery, pericallosal artery, & posterior pericallosal artery


Helpful Clues for Rare Diagnoses

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Aug 7, 2016 | Posted by in NEUROLOGY | Comments Off on Corpus Callosum Holes

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